Alcoholism is Not a Disease: Denial and the Alcoholic Psyche

Most of the information we receive about alcoholism is invented by outsiders. We sometimes hear anecdotes about personal experiences with alcoholism, but these tales often unfold like after school specials: subscribing to generalizations and stereotypes. I am an alcoholic. Some might say I’m a recovering alcoholic, but I’m not in rehab and I don’t go to AA meetings. Rehab and AA don’t work. The small percentage of people that actually remain sober after rehab remain so because they are ready and willing to change, not because of the twelve steps. Some of these very people might argue with me, but I don’t buy it. Many drug addicts (yes, alcohol is a drug) reach a point in their addiction at which they realize they cannot do it anymore. They come to a cross roads, so to speak, a place where they finally understand they have to make a decision: life or death? It is for these people that I write this.

One important thing to understand about alcoholism is that it develops over time. Alcoholism, like most everything in life, is a cycle with a beginning, middle, and end. Of course beginnings are never clear cut the way we’d like to imagine them, middles are deluded by tangled paths that progress and regress and digress before progressing once more, and endings, like beginnings, are rarely as distinct as we fancy and more often than not arrive “not with a bang but a whimper.” None the less alcoholism is a cycle. What begins as recreational drinking on special occasions turns into drinks every Saturday night. Every Saturday night becomes every night, every night becomes every afternoon, and every afternoon finally turns into every morning. All this occurs, like any evolutionary process, over time: weeks, months, and years.

Why do I believe that it is important to understand this? Because in order for an alcoholic to envisage a life without alcohol she must first recognize her addiction as habitual. Alcoholism is a creature of habit. There are beneficial habits and harmful habits, but every habit takes time and effort to establish. In other words, becoming an alcoholic is not easy. It doesn’t taste good at first, so you sip it slowly while trying to oppress the urge to twist your mouth into a foul look of disgust. Each shot burns as it rolls down the back of your throat and into your stomach. It even takes practice to learn how to swill shots down so that the liquid spends a minimal amount of time in contact with your taste buds. You get drunk easily at first and cannot keep up with your friends without getting sick or passing out. Only with time and concentrated effort do you finally build a tolerance, find that you can party all night long, actually start to enjoy the flavor, and find yourself drinking even when you’re alone. Developing the habit is a part of the process of alcoholism. Once the habit is established it becomes harder and harder to break. The longer it persists the more frequent the ritual. Dependency of any kind evolves through habit. Time establishes habit and time can likewise undo it. The sooner we begin the struggle to reverse the process the closer we are to replacing the alcoholic habit with a new and more positive one.

Is alcoholism really a disease?

Speaking of alcoholism in these terms makes it difficult to accept certain claims we have all heard declaring that it is a disease. Alcoholism is certainly related to psychopathology, but does this necessarily make alcoholism a disease? I do not believe that it does. Almost any human behavior or habit, positive or negative, could likely be linked to pathology. Alcoholism is, if anything, the symptom or sign of a greater problem. There may be myriad conscious and unconscious thoughts running through our minds, each guided by conflicting impulses and inhibitions, creating confusion and leading us to act contrary to our own best interests, but when it comes right down to it an alcoholic knows that it is a bad idea to pick up a bottle of Jack Daniels and start drinking. You know that it will lead you down a path of misery and devastation, but you crave it. You crave the pain and the desperation, you crave the bitter void that you know awaits you. Perhaps it could be argued that this very craving is evidence of disease and indeed it is a convincing argument, but it does not necessarily follow that alcoholism is itself a disease. The question still remains: if you know that what you are doing is destructive, if you are staring directly into a black abyss and choosing to follow it, then are you not in total control of your actions? On a daily basis there are a thousand things we might be driven to do by pathological lines of thought, but we still wouldn’t grab a loaded magnum and start picking off our co-workers. Only a psychotic would do something like that! Are alcoholics psychotics? I’m sure there are some cases in which they are, but most of us are just using this disease thing as another way of feeling sorry for ourselves.

As an alcoholic, I think that it is important for people to comprehend that disease is not the issue. Labeling alcoholism as a disease provides a new source of denial for addicts: instead of forcing the addict to admit that she controls her own behavior and is fully accountable for the results of that behavior, the idea of disease allows the addict to deny a certain level of control and use that denial as an excuse to continue destructive behavioral patterns. It is certainly true that alcoholics reach a point at which they are out of control, but they allow themselves to lose control. The very urge to drink comes from the desire to lose control and in most cases it is a fully conscious decision. Alcoholism is something that appeals to a particular personality and to a particular psychology. It is not a disease, but a self accepted path to destruction. The alcoholic loathes himself and all those around him and so he loses himself in a haze of drug induced oblivion. Unconscious factors may play a role, but it is still a conscious choice. Only if the alcoholic can come to accept responsibility for his own deterioration, can he begin to deconstruct the lies he has told himself about his addiction and possibly even dig his way out of the debris.

The role of denial.

There are many lies alcoholics use to justify their actions. One of these lies is that alcohol is necessary to having fun. The association of alcohol to having fun becomes an excuse for alcoholics which not only provides an explanation for the necessity of the presence of alcohol, but acts as a means of denial. Through this fabrication the alcoholic can claim that she is indulging in alcohol for the sake of social interaction while completely denying the fact that, conversely, she is using alcohol to avoid such interaction. Friends may get together for a drink after work from time to time or decide to order a couple of kegs for their party in order to promote fun, but alcoholism is not fun and fun is not the goal. When an alcoholic drinks she drinks to self loathing, destruction, oblivion, and finally death. Yes, death. That may sound extreme, but alcoholism, like any form of drug abuse, is a product of the death drive. Each drink delivers the alcoholic closer and closer to the brittle hands of death. An alcoholic blacks out on a regular basis; black out is a state which allows the alcoholic to exist in temporary oblivion; oblivion is annihilation; annihilation is death. This is the state that each and every alcoholic seeks.

Exploring the death drive.

You may be wondering what I mean by the death drive. Many readers may have encountered this concept previously and some may even have an in-depth knowledge of what it entails. For those who require a bit more detail in order to fully comprehend the connection I am making I will provide a brief explanation. The concept of the death drive comes from Freudian psychology. It is an extremely complex idea and one that continues to evolve with each new interpretation. The general understanding is that human beings are driven by two basic instinctual impulses. These impulses are what Freud calls Eros and Death. Eros obviously refers to the sex drive and the desire to procreate, while Death refers to what Freud describes as the desire to return to the state of quiescent inertia from which organic life has sprung. Eros and Death act in opposition to one another and yet they are essential to each others existence. The death drive is the instinctual impulse which motivates people to behave in a self destructive manner. Freud stipulates that everyone desires to die in their own way. This particular aspect of the death drive hints at the often stubborn persistence of an individual bent on a path of destruction. The deterioration of the mind and body that occurs throughout the various phases of alcoholism is a symptom of this instinctual pull toward the ultimate form of destruction in death itself.

More lies we tell ourselves.

So how do we conceive of a way out of this vicious cycle? This is where the choice I spoke of earlier comes into play. Unfortunately life is not as bright and full of hope as we have been raised to believe. The standards that we set for our children and the picture for the future we attempt to paint is a perversely distorted vision of an ideal society that will never exist. Perhaps if we were a little more honest with ourselves and our children we might not encounter such an intensely difficult period of adjustment to social reality. The point I am trying to make is that there comes a time when we either decide to accept the cruelty and indifference of the world at large, face it, and muster the courage to charge forward into it or we choose to wallow in our misery, allow our fear to consume us, and run as fast and as hard as possible from all responsibility for our own situation. The first choice is that of life, while the second is death. Alcoholism is a way of running, it is a way to hide from society, and thus from life. Alcoholics are not social people, they are quite the opposite. While drunk a person may be able to communicate without the same severity of inhibition, but what one finds the longer and the further they delve into alcohol is that what we communicate while drunk is a lie. It is a distortion of reality like the mental state it creates. It does not present the opportunity to more fully express one’s true self, it presents the opportunity to forget oneself, to forget others, to forget everything, and to speak the lies of one who has become lost in a haze of delusion. The only way out is to recognize alcohol as the lie that it really is and gradually attempt to develop a sense of self that one feels comfortable with.

The way we view ourselves is a part of the way others view us and the way others view us is a part of how we view ourselves. The face that we present to the outside world is a construction of elements we consciously control and unconscious elements we are incapable of controlling. Alcohol disrupts this interaction by diminishing our ability to make conscious decisions and finally destroying consciousness all together. Although initially we may convince ourselves that we drink because it calms our nerves, this is nothing more than an excuse contrived in order to forego the reality of a repression rising to the surface: we are not pleased with our self image and so we must discover a way to destroy our true self and create a false image based upon what we think others want of us. Alcohol facilitates this process by allowing us to act out our contrived persona while temporarily quieting the reality of our consciousness.

But isn’t there some degree of faÃ?§ade involved in all human interaction? Of course there is. The interface between the interior reality of the psyche and the exterior reality of the surrounding world makes it impossible for human beings to act fully on instinct and desire. However, this is a necessary exchange which becomes more and more highly developed over time and through greater levels of social organization. It is this essential communication that alcoholics attempt to destroy through intoxication. If we can eliminate the part of ourselves that dictates what actions, thoughts, and expressions are socially acceptable and which are not, then we can eliminate the inhibitions that warn us not to say or do certain things, and that often cause us a great deal of stress and anxiety both in immediate social interaction and in retrospect. We are looking to abolish inhibitions, but we cannot abolish all inhibitions, because inhibitions are a necessary element of human interaction. What the alcoholic seeks in her drunken haze is the courage to reveal certain parts of herself that she would ordinarily be too self conscious to show. To an extent alcohol does assist this release, however, it distorts and even annihilates judgment making it impossible for the alcoholic to distinguish between which ideas are valid and which are mere illusions created by the desire to feel or think a certain way. Ultimately alcoholism becomes a long descent driven by delusion and leading to humiliation, greater anxiety, deeper self loathing, and finally absolute despair.

Facing up to reality.

Instead of turning to a drug that allows us to create an illusion we ought to be attempting to understand what it is we are and what it is we would like to be. The first step in this process is to evaluate ourselves through the eyes of sobriety. There will always be self deception and there will always be certain things that we refuse to accept about who and what we are, but we must try to be as open minded as we can. It is important to listen to those around us and allow their perceptions of ourselves to act as reference points in our understanding of what we present to the outside world, even if we are sometimes troubled and pained by what others have to say. We have to turn our backs on self loathing and instead of wallowing in despondence begin building an ideal self within our minds. We cannot become too attached to this ideal as no ideal is fully attainable. However, to construct such an ideal and allow it to guide us toward actions that promote accomplishment and success will engender a better self image. Simultaneously these achievements will advance our position within society and turn us away from self loathing.

There will never be a time when pain and depression disappear and there will never be a place in which we feel that we are truly our whole selves. Sometimes we will imagine ourselves to be frauds and in these moments the self hatred will return, but by creating a better life for ourselves we will find these thoughts and feelings to be less frequent and we will discover that we are indeed headed toward becoming the self that is closer to what we desire. This is the choice of life. To live one must accept fear and suffering along side joy and accomplishment. Alcoholism offers nothing but anxiety, chaos, depression, and death. Sobriety offers all these things, but it offers something else that alcoholism can never provide. It offers comfort, structure, productivity, and life.

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